Abdul Mannan: A Direct Oral Anticoagulant Does Not Need an INR
Abdul Mannan, Consultant Haematologist at Betsi Cadwaladr University Health Board shared a post on LinkedIn:
“A direct oral anticoagulant does not need an INR.
It still needs a named review date.
The risk is not a missing blood test. The risk is an old VTE decision quietly becoming an unreviewed long-term prescription.
At the 3-month review, decide whether to stop, continue or change treatment. If treatment continues, make the next review visible.
At every review, ask:
- Is the indication still current?
- Is the drug and dose right for this phase of VTE treatment?
- Has bleeding, anaemia, kidney or liver function changed?
- Have aspirin, NSAIDs or interacting medicines appeared?
- Is there a procedure, admission, pregnancy plan or adherence problem?
NICE recommends reviewing general health, VTE recurrence risk, bleeding risk and treatment preferences at least yearly for people on long-term anticoagulation or aspirin after VTE.
This is not paperwork for its own sake.
It is how we make sure every anticoagulant prescription still has a current reason, a safe plan and someone responsible for the next decision.
What system does your service use to stop overdue reviews disappearing into the background?
Evidence: NICE NG158, recommendation 1.4.12, last reviewed 1 May 2026.”

Stay updated with Hemostasis Today.
-
Nov 13, 2026, 03:21Abdul Muqtadir Abbasi: Iron Deficiency Beyond Anemia and the Importance of Finding the Cause
-
Nov 13, 2026, 03:05Marc Carrier: Aspirin vs Anticoagulants for VTE Prevention After Joint Replacement
-
Nov 13, 2026, 02:28Julia Sjöberg: ROCK1 Inhibition and Red Blood Cell Recovery After Chemotherapy
-
Nov 13, 2026, 02:07Tonie Reincke: Understanding Deep Vein Thrombosis and Vascular Health
-
Nov 13, 2026, 01:52Akshita Singh: The Remarkable Process of Blood Clotting
-
Nov 12, 2026, 22:52Milka Koupenova: The Role of Platelet RIG-I in Regulating Thrombotic Responses
-
Nov 12, 2026, 22:50Arun V J: Why Has India Still Not Achieved 100% Voluntary Blood Donation?
-
Nov 12, 2026, 22:49Sickle Cell Disease Deserves to Be Prioritised in Ghana – ISCC
-
Nov 12, 2026, 22:47Samir Kumar Beura: Delighted to Serve as a Topic Editor for a Research Topic in Frontiers in Neuroscience